Glaucoma is an ocular disorder associated with elevated ocular pressures which are too high for normal function and may result in irreversible loss of visual function. If untreated, glaucoma may eventually lead to blindness. Ocular hypertension, i.e., the condition of elevated intraocular pressure without optic nerve head damage or characteristic glaucomatous visual field defects, is now believed by many ophthalmologists to represent the earliest phase of glaucoma.
Many of the drugs formerly used to treat glaucoma proved not entirely satisfactory. Indeed, few advances were made in the treatment of glaucoma since pilocarpine and physostigmine were introduced. Only recently have clinicians noted that a few .beta.-adrenergic blocking agents are effective in reducing intraocular pressure. While many of these agents are effective in reducing intraocular pressure, they also have other characteristics, e.g. local anesthetic activity, that are not acceptable for chronic ocular use.
(S)-1-tert-butylamino-3-[(4-morpholino-1,2,5-thiadiazol-3-yl)oxy]-2-propano l, a .beta.-adrenergic blocking agent, was found to reduce intraocular pressure and to be devoid of many unwanted side effects associated with pilocarpine and, in addition, to possess advantages over many other .beta.-adrenergic blocking agents, e.g. to be devoid of local anesthetic properties, to have a long duration of activity, and to display minimal tolerance.
.beta.-Adrenergic antagonists of the oxime type are known in the literature. Amino-2-hydroxypropyloximinofluorenes are described by Inibs et al, Br. J. Pharmacol., 60, 357 (1977) and Baldwin et al, J. Med. Chem., 25, 931 (1982); oxime ether derivatives of certain aromatic carboxaldehydes are described by Granados et al., Anales De Quimica, 79, 275 (1983); Oxime ether derivatives of thiochroman-4-ones are described by Fravolini et al., Eur. J. Med. Chem., 13, 347 (1978); and aliphatic and alicyclic oxime ethers are described by Baazoubba et al, J. Med. Chem., 27, 1291 (1984); 28, 896 (1985).
However, known .beta.-adrenergic blocking agents have not been shown to demonstrate any meaningful oculoselectivity and, in spite of the low dose normally required for ocular administration, manifest their .beta.-blocking properties in extra-ocular tissue, especially the pulmonary and cardiovascular systems to such an extent that they should not be administered to patients with pulmonary or cardiovascular ailments.
Now, with the present invention there are provided compounds, with .beta.-blocking properties some of which are particularly useful for topical optical administration for the treatment of ocular hypertension; pharmaceutical formulations of those compounds; methods of treating ocular hypertension, hypertension, angina and arrhythmia with those compounds and processes for preparation of those compounds.